title: Diagnostic and predictive value of urine PCA3 gene expression for the clinical management of patients with altered prostatic specific antigen.
abstract: OBJECTIVE
  Analyze the impact of the introduction of the study of PCA3 gene in post-prostatic massage urine in the clinical management of patients with PSA altered, evaluating its diagnostic ability and predictive value of tumor aggressiveness.
  
  
  METHODS
  Observational, prospective, multicenter study of patients with suspected prostate cancer (PC) candidates for biopsy. We present a series of 670 consecutive samples of urine collected post-prostatic massage for three years in which we determined the "PCA3 score" (s-PCA3). Biopsy was only indicated in cases with s-positive PCA3.
  
  
  RESULTS
  The s-PCA3 was positive in 43.7% of samples. In the 124 biopsies performed, the incidence of PC or atypical small acinar proliferation was 54%, reaching 68,6% in s-PCA3≥100. Statistically significant relationship between the s-PCA3 and tumor grade was demonstrated. In cases with s-PCA3 between 35 and 50 only 23% of PC were high grade (Gleason≥7), compared to 76.7% in cases with s-PCA3 over 50. There was a statistically significant correlation between s-PCA3 and cylinders affected. Both relationships were confirmed by applying a log-linear model.
  
  
  CONCLUSIONS
  The incorporation of PCA3 can avoid the need for biopsies in 54% of patients. s-PCA3 positivity increases the likelihood of a positive biopsy, especially in higher s-PCA3 100 (68.6%). s-PCA3 is also an indicator of tumor aggressiveness and provides essential information in making treatment decisions.
authors.affiliation: BIOPAT, Biopatologia Molecular, S.L., Grup Assistència, Barcelona, España. Electronic address: nrodon@biopat.es.
authors.forename: N
authors.initials: N
authors.lastname: Rodón
authors.affiliation: BIOPAT, Biopatologia Molecular, S.L., Grup Assistència, Barcelona, España; Histopat Laboratoris, S.L., Barcelona, España.
authors.forename: I
authors.initials: I
authors.lastname: Trías
authors.affiliation: BIOPAT, Biopatologia Molecular, S.L., Grup Assistència, Barcelona, España; Histopat Laboratoris, S.L., Barcelona, España.
authors.forename: M
authors.initials: M
authors.lastname: Verdú
authors.affiliation: BIOPAT, Biopatologia Molecular, S.L., Grup Assistència, Barcelona, España.
authors.forename: R
authors.initials: R
authors.lastname: Román
authors.affiliation: ICUN, Institut Català d'Urologia i Nefrologia, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Domínguez
authors.affiliation: Departamento de Estadística, Facultad de Biología, Universidad de Barcelona, Barcelona, España.
authors.forename: M
authors.initials: M
authors.lastname: Calvo
authors.affiliation: ICUN, Institut Català d'Urologia i Nefrologia, Barcelona, España.
authors.forename: J M
authors.initials: JM
authors.lastname: Banus
authors.affiliation: Analiza. S. Análisis Clínicos, Hospital Moncloa, Madrid, España.
authors.forename: A M
authors.initials: AM
authors.lastname: Ballesta
authors.affiliation: Unidad de Genómica y Reproducción Asistida, Hospital Clínico Universitario San Carlos, Madrid, España.
authors.forename: M L
authors.initials: ML
authors.lastname: Maestro
authors.affiliation: BIOPAT, Biopatologia Molecular, S.L., Grup Assistència, Barcelona, España; Histopat Laboratoris, S.L., Barcelona, España; Hospital de Barcelona, SCIAS, Grup Assistència, Barcelona, España.
authors.forename: X
authors.initials: X
authors.lastname: Puig
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000235:genetics / Q000473:pathology / Q000652:urine*; D000368:Aged; D000951:Antigens, Neoplasm / Q000096:biosynthesis / Q000235:genetics*; D014408:Biomarkers, Tumor / Q000096:biosynthesis / Q000097:blood / Q000235:genetics / Q000652:urine*; D001707:Biopsy, Needle; D055088:Early Detection of Cancer; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009363:Neoplasm Proteins / Q000096:biosynthesis / Q000235:genetics*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000235:genetics / Q000473:pathology / Q000652:urine*; D019564:Unnecessary Procedures
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; C479341:prostate cancer antigen 3, human; D017430:Prostate-Specific Antigen
keywords: Agresividad tumoral; Antígeno prostático específico; Cribado; Cáncer de próstata; Gleason; PCA3; Prostate cancer; Prostatic specific antigen; Screening; Tumor aggressiveness